Infertility testing.

[rex]

My primary care doctor is sending me for what she calls the first round of blood tests for infertility. She is appalled that I have not been referred to a specialist yet, and I'm hoping this means she will get me to one.

I have a slip for bloodwork for the lab and I can go whenever. I'm so nervous though because there's so many boxes checked off and so many
codes. I'm preparing for vials and vials of blood. I always pass out when I get blood drawn unless they lay me down.

Can anyone prepare me? What should I expect from these tests? Will they keep doing tests if they don't find something this round or is this it? Is it a lot of blood?

[GailGoldie]

don't stress - tons of tests doesn't always = tons of blood.

what is your history? i can give you more info/help if i know how old you are, how long you have tried, if you have normal cycles or not, etc.

also- your DH should have a SA done, too.... because nothing will help if his sperm is the problem and they only focus on you. An RE will know all the right things to do - so I'd see a specialist for sure- don't deal with your PCP or OB for IF issues.

[Deleted]

Do you need a referral? I ask because my OB ran some tests on me at first and then said there was nothing wrong but never actually told me what my results were until months later when I requested the records a second time. It turns out my LH: FSH ratio or some other such thing was off but that was really the only "problem" I had on CD3. Are you going to get tested on CD3? Can you just skip the primary and get an appointment with an RE? And they did take three beakers of blood but they're really used to doing it so it's not nearly as bad as giving blood with a regular nurse.

[badtzmaru22]

Here is a website I like with what to test and when: fertilityplus.com/faq/hormonelevels.html

You can probably look at your lab slip and figure out what tests she has ordered for you already.

[rex]

I'm mid-twenties, 2 m/c in 9 mos of trying. I have very regular cycles in that my period comes on the exact same day every cycle, I have 27 day cycles but I think I tend to O late (I don't temp, I probably should).

Do I just ask my PCP for a referral? My OB wanted me to wait for another m/c before testing but I agree that at this point I need tests. There's no point in putting me through another m/c if I don't need to.

From that website it looks like she's running a complete blood count, testing for anemia and antiphospholipid syndrome (clotting?).

[drloretta]

It depends on what she's testing for. There isn't a "standard" IF panel, and your dr may test you for specific things based on your history. That being said, you're looking at maybe 3 vials tops, and it's all from one stick so it won't take long. You may have more done if you go to a specialist, but it's a good start. Is she doing any Day 3 or Day 21 testing? I'm kind of surprised she isn't at some point.

Here's a link on APA testing. It's kind of geekified, but you should get the gist.
www.millenova.com/tests/apa.cfm

[statlerwaldorf]

It has been so long ago that I don't remember what the first blood tests were. They did find something off and scheduled me for an ultrasound. I was diagnosed with PCOS. My doctor pretty much knew I had it before even testing. I had all of the symptoms.

How long have you been TTC? Do you have regular cycles? Have you tried basal body temp charting?

[rex]

Thank you all!! You have been so helpful. I'm going to call my Dr. this week and ask about a referral.

[Deleted]

I used to get blood drawn fairly often and always got lightheaded/sick/passed out. Then a phlebotomist told me the trick was to drink a ton of water before you go, and it will be easier to find a vein (if that's your problem, I have very small veins so I would always wig out when they couldn't find a vein). Since then, I have had no issue having blood drawn.

[ejpint]

I had a similar start - they took three vials, it was pretty painless. This was recommended by my OB/GYN at the time. According to her, everything came back "normal", but I got no further information. We had been trying for over a year, and had one chemical pregnancy. Her advice? "Have more sex". I stopped seeing her after that.

I had an appointment with my PCP a month or so later, and she was much more understanding. They did standard bloodwork as part of my annual physical, and it was there I learned of my thyroid issues. She spoke to me more about PCOS, and I decided to go directly to an RE.

He talked about what "normal" ranges are, and how they can look very different to a family doctor than to an endocrinologist. After some bloodwork, an ultrasound and some other testing, I was given an increased dose of medication for my thyroid, and was diagnosed with PCOS. Metformin to help with the PCOS and Femara to stimulate ovulation, and two cycles later we're pregnant. It's still super early, but fingers crossed that this is it.

Good luck!

[statlerwaldorf]

My old insurance required a referral from my ob/gyn. I would talk to the RE office. Mine does not do testing until the 3rd m/c.